BEFORE THE DISTRICT CONSUMER DISPUTES REDRESSAL FORUM

CACHAR :: SILCHAR

Con. Case No. 43 of 2014

Saleha Begum Laskar,

W/o Md. Rafique Uddin Laskar

Vill & P.O. Krishnapusr, Via Arunachal, P.S. Silchar …………………………..Complainant.

                                                                        -V/S-

                        TATA AIG Life Insurance Co. Ltd.

                        Represented by its Branch Manager,

                        Shyamaprasad Road, Shillongpatty, Silchar-1 ……………………………    Opp. party

Present: -                                Sri Bishnu Debnath,                                         President,

District Consumer Forum,

                                                Cachar, Silchar.                                            

                                                            Sri Kamal Kumar Sarda,                                       Member,

                                                            District Consumer Forum,

                                                            Cachar, Silchar.       

            Appeared: -                Mr. Rajesh Dhar, Advocate for the complainant.

                                                Mr. Kajal chanda, Advocate for the O.P

                            Date of Evidence                   06-09-2016, 19-05-2017

                         Date of written argument        19-07-2017

                         Date of oral argument               17-03-18, 29-03-18, (30-10-18, None has argued)

                         Date of judgment                       12-11-2018

JUDGMENT AND ORDER

                                 Sri Bishnu Debnath

1. Mother of the deceased life Assured brought this complaint under the provision of the Consumer Protection Act 1986 against TATA AIG LIFE Insurance Co. Ltd. for award of death benefit of deceased life assured in connection with Insurance Policy No. U068210010 and insurance Policy No. U144270233 because the insurance company repudiated the claim No. K013001482 against the policy No. U068210010 by making payment of Rs.42,659.99/- through cheque No. 017920 dated 08-04-2013 of HDFC Bank, Mumbai and also repudiated the claim No. GU13001487 in respect of Policy No. U144270233 by making payment of Rs.53,848/- through cheque No. 230887 dated 21-06-2013 of HDFC Bank, Mumbai.
2. The complainant stated inter-alia that during the validity of aforesaid insurance policies her son i.e. life assured died due to heart attack on 18-10-2012 and thereafter necessary information was given to the insurance company and submitted her claim being nominee but the insurance company offered the above mentioned amount which is much below the sum insured.
3. The insurance company submitted W/S. In the W/S admitted the fact that the deceased life Assured Aman Uddin Laskar purchased insurance policy No. U068210010 and insurance policy No. U144270233 where sum insured were Rs.5,00,000/- and 1,50,000/- respectively but both the policies were lapsed due to non-payment of premium. As such on issuance of notice the deceased life Assured reinstated the policy No. U144270233 by submitting fresh health certificate as per rule. It is further stated that the health certificate was submitted on 11-10-2012 and accordingly the said policy has been reinstated with effect from 15-10-2012. The O.P. in their W/S stated inter alia that in the health certificate the deceased life Assured suppressed his disease which caused him death i.e Non-Hodkins Lymphoma i.e Cancer, for which death benefit was not granted.                             
4. During hearing the complainant submitted deposition and relevant documents in support of her claim but no medical documents submitted to establish the fact the deceased life assured died due to heart attack. Rather the insurance company submitted medical papers along with the deposition of Sujit Kanti Shee vide Ext. C and Ext. D. The said medical paper make out a fact that the deceased life assured was admitted to Cachar Cancer Hospital and Research Centre on 03-09-2012 with prior diagnosed Non-Hodgkins Lyomphoma (NHL) and for that he already underwent cancer directed treatment in Dr. B. Borooah Cancer Institute, Guwahati vide Hospital No. A-55015.
5. I have also perused the health certificate dated 11/10/2012 which was used by the deceased life assured to reinstate the lapsed policy. In that health certificate he has suppressed his above ailment.
6. Thus, it is crystal clear that at the time of reinstatement of the lapsed policy the deceased life assured suppressed the disease from which he was actually suffering. Hence, in this case I do not find any disservice or deficiency of service of the insurance company for not granting full death benefit.
7. Accordingly, in this case, the complainant is not entitled any relief from this District Forum. Thus, this case is dismissed on contest. Supply free certified copy of judgment to the parties. Given under my hand and seal of this District Forum on this the 12^th day of November 2018.